Comparing approaches for advanced e-health security infrastructures
Comparing approaches for advanced e-health security infrastructures
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DOI：
10.1016/j.ijmedinf.2006.09.012
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发表时间：
2007-05-01
影响因子：
4.9
通讯作者：
Blobel, Bernd
中科院分区：
文献类型：
--
作者：
Blobel, Bernd
目的：所有发达国家的医疗系统都面临着提高患者护理质量、效率和安全性的挑战。为了应对这一挑战，卫生正从以组织为中心转向以流程为基础的护理。这一进程将在未来继续，将健康转向以人为中心的建筑。这一系统转型与适当的信息和通信技术(信通技术，也称为电子保健)的支持和支持下的扩展和高级通信与协作相结合。最终的解决方案必须是可信的。方法：实现可信的电子健康解决方案需要一套安全服务。这些安全服务必须全面整合到电子健康应用中。此外，还必须指定和实现一组基础设施服务。为了保持解决方案的前瞻性，它们必须遵守架构原则和范例。结果：在简要介绍了国际公认的应用程序架构范例、提供安全服务的手段和基础设施之后，描述并比较了现有的或特定的高级解决方案。在这方面，作为电子健康核心应用的电子健康记录得到了特别的考虑。根据已发表的工作以及探索的解决方案，总结和评估了所需的安全服务。收集和解释了调查实例的利弊。在这种背景下，特别是德国健康远程信息处理框架架构和安全基础设施以及相应的可实施解决方案和美国退伍军人健康管理局对安全的方法进行了仔细的考虑。结论：流程和系统由政策决定，这些政策定义和区分通信和协作的约束。因此，正式建立政策模型和执行政策衔接是需要应对的主要挑战。作为调查的结果，提出了从区域到国家、欧洲甚至全球的不同级别的任何电子健康解决方案所需的可信度的建议，这些建议包括在会议摘要中。(C)2007爱思唯尔爱尔兰有限公司。保留所有权利。
Objectives: The healthcare systems of all developed countries face the challenge for improving quality, efficiency and safety of patients' care. For meeting this challenge, health is moving from being organisation-centred to process-based care. This process will continue in the future turning health towards person-centred architectures. This system transformation is combined with extended and advanced communication and collaboration supported and enabled by appropriate information and communication technologies (ICT), also called e-health. The resulting solutions have to be trustworthy.Methods: There is a set of security services needed for realising trustworthy e-health solutions. Those security services must be comprehensively integrated in the e-health application. Furthermore, a set of infrastructure services has to be specified and implemented. For keeping the solutions future-proof, they have to comply with architectural principles and paradigms.Results: After shortly introducing meanwhile internationally acknowledged architectural paradigms for applications, means and infrastructures providing security services, existing, or specified advanced solutions are described and compared. In that context, the Electronic Health Record as e-health core application has been especially considered. Based on published work as well as on explored solutions, the security services needed are summarised and evaluated. The pros and cons of investigated examples are collected and interpreted. In that context, especially the German health telematics framework architecture and security infrastructure and the corresponding implementable solutions on the one hand and the USA Veterans Health Administration approach to security have been carefully considered.Conclusion: Processes and systems are determined by policies, which define and distinguish constraints for communication and collaboration. Therefore, formally modelling policies and performing policy bridging are the main challenges to be met. As result of investigations, recommendations have been derived for establishing the trustworthiness required for any e-health solution at different level from regional to national, European, and even global scale, which are included in the conference summary. (C) 2007 Elsevier Ireland Ltd. All rights reserved.